What should be done about noticeable scar in corner of one eye after eyelid surgery? (Photo)

Question

Surgery was performed 5 months ago, and the corner of one eye developed a thick red scar. Revision surgery was performed 6 weeks ago on this scar, and now it is an even more noticeable thick scar that is rough to the touch. Any advice on what should be done at this point?

Sean R. Weiss, MD, FACS · Answer

You appear to have a hypertrophic scar.  At this point you can try using silicone tape on the scar or using a very low dose steroid injection.  Often times I will combine this with 5FU and scars typically become less noticeable with this approach.  Discuss your concerns further with your surgeon to develop a plan.  Best regards.

John J. Martin, Jr., MD · Answer

You would benefit from some injections at this point since you are forming a hypertrophic scar, which I assume happened the first time as well.  I like to use a combination of 5-FU and kenalog - a steroid.  With one injection you should get significant flattening of the scar.  Just don't want to use too strong a steroid or it can get depressed and white.  Laser resurfacing with a non-ablative fractionated resurfacing laser can also work very well, and 6-8 weeks after surgery is the best time to do this.

Chad Robbins, MD · Answer

I agree with the previous Surgeon, I would inject my patient with a steroid that stays in the scar, is not a systemic steroid.  One injection with a small needle should be plenty, this will flatten and soften it.

Inessa Fishman, MD · Answer

Your scar would likely benefit the most from a tiny injection of steroid.  I used a combination of dilute Kenalog (an anti-inflammatory steroid; also called triamcinolone) and an anti-scarring medication called 5-FU and see great results even after 1 injection.  At times, more than 1 injection may be required for a particularly stubborn scar, though this scenario is unlikely in the delicate eyelid area.  While a steroid injection will likely soften the raised and bumpy scar, the associated redness should improve with time.  Redness may also be decreased with IPL (intense pulsed light) or PDL (pulsed dye laser) treatment.  Good luck!

Mark Petroff, MD · Answer

I'm sorry you're experiencing scarring from your procedure.  As mentioned below, 6 weeks following revision is too soon to make a final decision on how the scar will heal. Try gently massaging the scar   If you have more specific questions, I recommend visiting your surgeon.  The two of you can decide what option is best for continued treatment.  Good luck as you continue to heal.Mark Petroff, MD., FACS

Remus Repta, MD · Answer

Thank you for the question and the photos.  Since your scar revision was six weeks ago I would follow your surgeons recommendation for a while longer to see how the scar appearance is after full healing.  I suspect massage and time will make it better.  Taping the scar with paper or silicon tape may also be of benefit.  Injection of steroids in this area especially at this early time after your revision is not likely to be a good option since it can easily cause other problems.  A secondary revision once it is all healed may be reasonable.  How the revision is performed and closed is important since that may also be a factor in your healing.All the best,Dr. Remus Repta

What should be done about noticeable scar in corner of one eye after eyelid surgery? (Photo)

Answers (6)

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